Success of oral test for HIV may improve screening

Could HIV testing soon move out of the clinic and into the home? Maybe. A look at global success rates of a HIV saliva test shows that it’s nearly as effective as the more common blood test. And, since showing up for a blood test can discourage at-risk people from learning their status, the oral test — Oraquick — could lead to more thorough screening.

A team from McGill University in Montreal, Canada reviewed published reports of Oraquick in the journal The Lancet Infectious Diseases. They found that Oraquick was 99 percent as effective in at-risk populations as the traditional blood test. In low-risk populations, the oral test was 97 percent as effective. The saliva test is faster, pain-free and non-invasive, too — all of which could lead to better testing of at-risk populations. That means earlier treatment for those infected.

Better administration and ensuring tests are used promptly could further improve the success of the oral test. But the real promise for public health is that this oral test could soon allow patients around the world — including in the hardest-hit countries in southern Africa — to avoid the persistent stigma and shame of an HIV test by taking it at home.

Oraquick received FDA approval for use with saliva in 2004 and has been used in home-based testing efforts in Kenya and Uganda. In the future, countries, including the United States, could approve it as an over-the-counter HIV test, extending its confidentiality. National HIV Testing Day is June 27. While eradication of HIV remains an elusive goal, increased testing could reduce its spread, an important step. While testing at home may give more people early knowledge of their infection status, the report’s authors caution that without access to treatment, the test alone won’t improve disease outcomes.